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Archive for November, 2011

Concomitant axillary mycobacteriosis and neuro-sarcoidosis: diagnostic pitfalls

30 Nov, 11 | by Emma

Diagnostic pitfalls

Here the authors discuss the difficulties in differentiating microbial (in particular tuberculous) causes of intrathoracic lymphadenopathy and sarcoidosis; indeed, sarcoidosis may occur in patients with previous microbial infection just as TB occurs in patients who are HLA B27 positive. Case reports are an excellent platform for diagnostic debate and the discussion of pitfalls.

Seema Biswas
Editor-in-Chief

Concomitant axillary mycobacteriosis and neuro-sarcoidosis: diagnostic pitfalls

Unilateral onycholysis in a patient taking erlotinib (Tarceva)

23 Nov, 11 | by Emma

Rare side effect of treatment

Here the authors present a case of unilateral onycholysis in a patient receiving an EGFR tyrosine kinase inhibitor. In addition to describing a possible mechanism for this side effect, the authors also highlight the benefits of targeted therapy.

Seema Biswas
Editor-in-Chief

Unilateral onycholysis in a patient taking erlotinib (Tarceva)

The use of intraoperative PET probe to resect metastatic melanoma

16 Nov, 11 | by Emma

Introducing novel methods of investigation and treatment

Here the authors report two cases of metastatic melanoma resected with the assistance of an intraoperative handheld positron emission tomography (PET) probe. The probe was used to identify hypermetabolic lymph nodes and after resection the probe reading returned to background levels. At follow up the patients remained disease free.

Seema Biswas
Editor-in-Chief

The use of intraoperative PET probe to resect metastatic melanoma

Botulism cases in Scotland linked to jars of curry sauce

14 Nov, 11 | by Dr Dean Jenkins

Botulism, due to food contaminated with Clostridium botulinum, is rare in the UK but two cases in one family in Scotland have led to the withdrawal of a particular batch of ‘Loyd Grossman Korma sauce’ by the Health Protection Agency over the weekend.

http://www.hpa.org.uk/NewsCentre/NationalPressReleases/2011PressReleases/111113botulism/

The place of case reports in medical literature: Periorbital cellulits – a mistaken diagnosis!

9 Nov, 11 | by Emma

Case reports offer level IV evidence ranked well below randomised control trials and meta-analyses.

http://healthpolicyandreform.nejm.org/?p=14876&query=TOC

What role do case reports have then in the medical literature? Certainly, the report of adverse events, the opportunity to discuss diagnostic pitfalls, present novel methods of investigation and treatment and, of course, present cases of enormous interest and concern.

Over the next few weeks we hope to present a series of reports that illustrate these examples of the relevance of case reports in modern evidence based medicine. Here is the first…

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A near miss

A 12 year old healthy girl presents with unilateral periorbital swelling, purulent discharge, pain in her jaw and palpable cervical lymphadenopthy. An initial diagnosis of preseptal cellulitis is made, but, in spite of a course of conventional broad spectrum antibiotics, the symptoms progress. A careful history and further investigation leads to a diagnosis of cat scratch disease and treatment is adjusted.

Seema Biswas
Editor-in-Chief

Periorbital cellulits – a mistaken diagnosis!

Pathology: Primary bladder amyloidosis

2 Nov, 11 | by Emma

An 89 year old lady presents with painless haematuria and is found to have an extremely unusual lesion of the bladder. The pathology is discussed in detail and microscopy reveals stunning images…

Seema Biswas
Editor-in-Chief

Primary bladder amyloidosis

BMJ Case Reports: publishing, sharing and learning through experience

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